Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Semin Arthritis Rheum. 2013 Oct;43(2):209-16. doi: 10.1016/j.semarthrit.2013.04.003. Epub 2013 May 31.
Systemic lupus erythematosus (SLE) patients are at risk for complications that can be mitigated by appropriate preventive care. We examined the receipt of immunizations, cancer screening, and cardiovascular risk preventive services in a predominantly Black cohort of SLE patients from the Southeast U.S. To identify gaps in primary preventive services (PPS) that might be specific to SLE as opposed to local health system factors, we used as reference a population-based sample from the same area.
A cross-sectional design was used to characterize the percentage of PPS received by 751 SLE patients from Atlanta, GA, and 9040 subjects from the same community, of whom 938 had diabetes. Factors associated with the receipt of PPS were examined with multivariable analysis of variance.
Approximately 65% of recommended PPS were provided to the SLE, overall community (OC), and diabetes samples. However, only 22.5%, 45.7%, and 27.6% of SLE, OC, and diabetes subjects, respectively, received all recommended services. Factors associated with a higher percentage of PPS received by SLE patients included older age (63.6% if age ≥65 years, 45.8% if age between 18 and 35 years), having medical insurance (61.1% for insured, 49.7% for uninsured), having a primary care physician (PCP) (59.0% if patient had PCP, 51.8% if patient did not have PCP), and being a non-smoker (61.9% for non-smokers, 49.9% for smokers).
Less than one-quarter of SLE patients from a southeast U.S. community received all the recommended services that were studied. Further research is warranted to unravel the barriers that prevent SLE patients from reaching appropriate standards of preventive care.
红斑狼疮（SLE）患者存在并发症风险，适当的预防保健可以减轻这种风险。我们在美国东南部的一个以黑人为主要群体的 SLE 患者中检查了免疫接种、癌症筛查和心血管风险预防服务的接受情况。为了确定可能是 SLE 特有的初级预防服务（PPS）差距，而不是当地卫生系统因素，我们使用了来自同一地区的基于人群的样本作为参考。
采用横断面设计，描述了来自佐治亚州亚特兰大的 751 名 SLE 患者和同一社区的 9040 名受试者（其中 938 名患有糖尿病）接受 PPS 的百分比。使用多变量方差分析检查与 PPS 接受相关的因素。
总体而言，建议的 PPS 约有 65%提供给了 SLE、总体社区（OC）和糖尿病样本。然而，只有 22.5%、45.7%和 27.6%的 SLE、OC 和糖尿病患者分别接受了所有推荐的服务。与 SLE 患者接受更多 PPS 相关的因素包括年龄较大（如果年龄≥65 岁，为 63.6%；如果年龄在 18 至 35 岁之间，为 45.8%）、有医疗保险（有保险者为 61.1%，无保险者为 49.7%）、有初级保健医生（PCP）（有 PCP 者为 59.0%，无 PCP 者为 51.8%）和不吸烟（不吸烟者为 61.9%，吸烟者为 49.9%）。
来自美国东南部社区的 SLE 患者中，不到四分之一的人接受了所有研究中建议的服务。需要进一步研究以揭示阻止 SLE 患者达到适当预防保健标准的障碍。
